Sorry, Mudder, but I have to disagree with you. There has been a tremendous move toward Patient-Centered Medical Homes (PCMH) and Patient Centered Specialty Care all across the country. We grew up with Doctor-Centered practices. Your Villages Health practice is an NCQA Level 3 PCMH. (I am not eligible to go there). One of the standards of PCMH is that PCP practices coordinate all the care of their patients.
Patient-Centered Medical Home PCMH Specialists resist this coordination, probably because they don't want to cede control to PCPs, but we as consumers should be holding them to it. Almost every practice in the country now has an electronic medical record system and they can talk to each other, if the practices want them to. There are a few other PCP practices that are certified PCMHs here near the Villages, but not many. If we 120,000 seniors wanted to rise up as consumers we would have a lot of power.
I moved here from Washington, DC. Not a small town. Most of the PCP practices were owned by big outfits like Johns Hopkins, Inova, or Medlantic. The PCP practices were all NCQA certified PCMHs. There was tremendous competition amongst them, and also great coordination of care.
We are seniors. Many of us don't have the background to understand the health care system. Others are frail and can't coordinate their care anymore. I have walked into a specialist's waiting room and seen dozens of very elderly patients who are in wheelchairs and need a lot of assistance to get to the doctor. When I see this scene I can't help but wonder if there is Medicare claims churning going on, because old folks like this need a lot of coordination of care to avoid wasting health care dollars. I will be one of the frail elderly soon enough, and I sure would like to be able to trust my physicians to coordinate my care so I don't fall through the cracks or end up with unnecessary out-of-pocket costs.
I will continue to coordinate my own care if I can't depend on my PCP and specialists to do it. Wish I didn't have to.